As recently as July, the bishops’ conference had largely embraced the president’s goals, although with the caveat that any health care overhaul avoid new federal financing of abortions. But in the last two weeks some leaders of the conference, like Cardinal Justin Rigali, have concluded that Democrats’ efforts to carve out abortion coverage are so inadequate that lawmakers should block the entire effort.

Others, echoing the popular alarms about “rationing,” contend that the proposals could put a premium on efficacy that could penalize the chronically ill.

“No health care reform is better than the wrong sort of health care reform,” Bishop R. Walker Nickless of Sioux City, Iowa, declared in a recent pastoral letter, urging the faithful to call their members of Congress.

In a diocesan newspaper column this week, Archbishop Charles J. Chaput of Denver agreed. “Fast-tracking a flawed, complex effort this fall, in the face of so many growing and serious concerns, is bad policy” he wrote. “It’s not only imprudent; it’s also dangerous.”

The bishops’ opposition — published in diocesan newspapers, disseminated online by conservative activists, and reported in a Roman Catholic newspaper to be distributed this weekend at churches around the country — is another setback for Mr. Obama’s health care efforts. His administration has been counting on the support of Catholic leaders to help rally believers behind his health care plan. Just last week, he held a conference call with 140,000 religious voters to appeal to what he called their “moral convictions.”

The bishops’ backlash reflects a struggle within the church over how heavily to weigh opposition to abortion against concerns about social justice.

“It is the great tension in Catholic thought right now,” said M. Cathleen Kaveny, a professor of law and theology at Notre Dame.

The same question, Professor Kaveny said, set off the debates over whether conscientious Catholics could vote for Mr. Obama despite his support for abortion rights, whether he should be invited to speak at Notre Dame, or whether Catholic politicians who support abortion rights, like Vice President Joseph R. Biden Jr., should present themselves for Communion.

Mr. Obama has said the health care overhaul should preserve the current policy that federal money not pay for elective abortions, and congressional Democrats say they are trying to do that. House health care legislation would allow the secretary of Health and Human Services to decide whether a proposed government insurance program would cover abortions. But any health insurance plan that does cover abortion — whether government-run or private — would be required to segregate its government subsidies from its patients’ premium payments so that no taxpayer money would pay for the procedure. And all patients would have the choice of plans that do and do not cover it.

House Democrats say many states similarly segregate federal money when they cover abortion under Medicaid. But abortion opponents say they take as a model the federal employees benefits program, which excludes health plans that cover abortion.

In an Aug. 11 letter to Congress, Cardinal Rigali of Philadelphia, head of the bishops’ anti-abortion efforts called the proposed division of funds “an illusion,” arguing that taxpayers would still indirectly help cover abortion. He urged lawmakers to block the current House legislation from coming up for a vote unless it can be amended to expressly prohibit financing for the procedure.

In his conference call with religious voters last week, Mr. Obama denied that his plan would mean government financing for abortions, calling such assertions “fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation.”

Now, a prominent Catholic newspaper, Our Sunday Visitor, is declaring that the president was wrong, citing Cardinal Rigali’s letter about the House bill.

“U.S. Bishops, fact-checkers contradict Obama’s health claims on abortion,” declares the headline in the issue of the paper that will be distributed in many churches this weekend.

Liberal Catholic groups argued that most bishops still strongly supported the broader goals of the health care proposals. “There are certainly some strident voices out there that want to see health care reform abandoned on the back of this issue,” said Victoria Kovari, acting director of the liberal Catholics in Alliance for the Common Good, “but I don’t think that is where the bishops are.”

As recently as July 17, a letter to Mr. Obama and Congress from Bishop William F. Murphy, chairman of the bishops’ domestic justice, appeared eager to back the Democrats’ effort.

Bishop Murphy of Rockville Centre, N.Y., noted that the “we strongly oppose inclusion of abortion as part of a national health care benefit.” But he emphasized the priority the church placed on coverage for the poor, calling health care “not a privilege but a right.”

“Health care is not just another issue for the Church or for a healthy society,” he wrote. “It is a fundamental issue of human life and dignity.”

On its Web site this summer, the bishops’ conference published a commentary by the Rev. Douglas Clark of Savannah, Ga., arguing that the country now rationed “health care on the basis of wealth.” Father Clark cited an encyclical last month from Pope Benedict XVI about the evils of global economic inequality.

Catholic Charities and the Catholic Health Association have supported the president’s overall approach, but have also said they would oppose any legislation that used federal funds to pay for elective abortions or required health care workers to participate in abortions over their objections.

But as the focus has shifted to the health care overhaul’s ramifications for abortion provisions, bishops who oppose it on many grounds have grown more vocal.

“The Catholic Church does not teach that government should directly provide health care,” Bishop Nickless of Sioux City wrote, adding, “Any legislation that undermines the vitality of the private sector is suspect.”

Correction: August 29, 2009

An article on Friday about an increasing number of bishops who are speaking out against President Obama’s health care plans overstated the support of Catholic Charities and the Catholic Health Association for the president’s plans. While both organizations have supported his overall approach, they have also said they would oppose any legislation that used federal funds to pay for elective abortions or required health care workers to participate in abortions over their objections. (The president has said he agrees with both principles.) The two organizations have not endorsed his proposals “without reservation.”

Correction: September 2, 2009

An article on Friday about Catholic bishops’ criticism of the push to overhaul the health care system this year quoted incompletely from an article that Archbishop Charles J. Chaput wrote on the subject. He said: “Fast-tracking a flawed, complex effort this fall, in the face of so many growing and serious concerns, is bad policy. It’s not only imprudent; it’s also dangerous.” He did not say the legislation itself was imprudent and dangerous.

A version of this article appears in print on , on page A1 of the New York edition with the headline: Despite Church’s Push on Issue, Some Bishops Assail Health Plan. Order Reprints|Today's Paper|Subscribe